Should you sign off on the surgery and allow Dr. G to operate on Mishael?
DB 1 Ethical Questions
1) Should you sign off on the surgery and allow Dr. G to operate on Mishael?
2) Is there any additional information you need to make a decision? If so, what information
and how would it impact your decision?
3) What ethical frameworks or methods could you use to help make this decision?
DB 2
Answer this question:
– What is ONE new knowledge, skills, or competency you feel is greatly needed
to teach other nurses about developing partnership to improve population health? Provide your rationale.
Global Healthcare Ethics: Case Study You are the nurse leader for a healthcare mission trip to Peru organized by a nonprofit group in the United States. The team members are drawn from various health systems in the US and are all licensed and in good standing with their relevant boards and health systems. The team has traveled to Peru to provide care in a local hospital that has limited resources and only 2 physicians trained by the Peruvian medical school system in family medicine. They are competent physicians, but they did not have exposure or training in complex medical procedures as practiced in the United States and the local hospital is not well resourced by US standards. Your team will be bringing a significant number of supplies on the trip to help update and replenish the hospital’s resources. During the last week of your trip, a family brings their 5 year old child Mishael into the clinic for help. Mishael has a tumor in her mouth that has grown sufficiently large to be causing her problems with eating and drinking. While she is currently well nourished, the expectation is that without intervention and treatment, within the next 2 months she will be unable to take in adequate nutrition and will most likely die. Due to their poverty and the remoteness of their home, Mishael’s parents are unable to take her to another Peruvian hospital for more complex care and are Mishael is unable to travel outside Peru for treatment. Your team includes Dr. G a skilled general surgeon from a respected hospital in the US. Mishael is brought to Dr. G for evaluation and to see if her tumor can be successfully removed. Dr. G does not typically practice surgical oncology in the US, and he would not be licensed to provide this surgery in his home state and facility. However, Dr. G has been part of surgical oncology cases and observed a similar surgery during his residency and fellowship. He has also contacted a colleague in the US and received a detailed description of the necessary procedure. From his initial evaluation, this does not look like it will be a complicated case and he believes he could successfully perform the surgery. There are also two nurses on the team who work with surgical oncology patients and have volunteered to care for Mishael after the surgery and to teach a local nurse to provide the necessary standard follow up care. Expected recovery time for Mishael following the surgery is about 4 weeks. Dr. G has met with the family and told them he believes he can perform the surgery and save Mishael’s life. The family has asked him to proceed with the surgery. There are no laws or regulations surrounding informed consent, and the family has a deep trust in healthcare providers from the United States. They agreed to the surgery without the standard informed consent conversation and do not seem to believe they have the authority to ask any questions or to request further information about the treatment or Dr. G’s credentials. As the nurse leader for the trip, you must sign off on the surgery before it can move forward. Dr. G is the medical director of the trip and has asked you to serve as a second set of eyes and to give him your assessment of whether or not to proceed. He believes that some help
is better than nothing, and that he should be permitted to move forward. Mishael’s parents are also hoping you will approve. Ethical Questions 1) Should you sign off on the surgery and allow Dr. G to operate on Mishael? 2) Is there any additional information you need to make a decision? If so, what information and how would it impact your decision? 3) What ethical frameworks or methods could you use to help make this decision?
Discussion Board Assignment Instructions Discussion Board #5 Purpose: The discussion board format is an online forum that is a safe space in which students can engage in a asynchronous discussion on the topic of choice. Students are to gather information needed to show critical thinking, apply course content, using evidenced based information to support their point of view and engage their fellow peers in a discussion. Student Learning Outcomes: 1. Apply knowledge of liberal arts and sciences in combination with the evolving body of nursing knowledge to develop and refine clinical judgment as the foundation of the practice of nursing. 2. Foster human flourishing through the delivery of holistic, ethical, developmentally appropriate, person-centered care that extends compassion to those in need. 3. Apply knowledge of health promotion strategies to promote the delivery of just and equitable care that reflects cultural humility, inclusivity, consideration of social determinants of health, and advocacy. 4. Utilize a spirit of inquiry that seeks to improve health outcomes using evidence-base care as the foundation of nursing practice. Click here to access your groups and this week’s discussion board. Once in your group click on “Group Discussion Board” and you will see your assigned discussion board. Course Objective: 1. Demonstrate elements of the inter-professional team concept that will help advocate for the seriously ill patients and their families for palliative care- 2. Advocate for the need for palliative care for seriously ill patients and their families, from the time of diagnosis, as essential to quality care and an integral component of nursing care. Discussion Board Instructions:
You are now beginning Step 4 which is your clinical debriefing. In this step you will move towards assimilation and accommodation to apply what you have learned in this course to future situations (NLN, 2013). All the course participants have been divided into discussion groups. Please ask questions to your peers to facilitate everyone’s learning and respond to questions asked to you by classmates and faculty. If your faculty or a peer has asked you a question, it is important to post a respond to show your participation in the discussion. You are required to submit one initial post with in-text citation/references and respond to at least two (2) of your peers. Discussion board rubric: located on the right-hand side of this page. Refer to the discussion board rubric in your preparation of your responses. If you have any questions, please post them in “Ask the Faculty.” Due per course calendar. Discussion Board Topic Instructions: 1. Click the “Discussion Board #5” title above to access your groups and this week’s discussion board. Once in your group click on “Group Discussion Board” and you will see your assigned discussion board. 2. For this discussion board consider this situation: “Care coordination has great implications for nurse. You have learned about the mandate of the triple aim is clear and universally supported. You have also learned that the trend to enhance wellness-oriented population health and value-based payment systems is being implemented across the country. To improve population health, nurses will need to have different skills to help address the needs of vulnerable populations. You are a nurse on a medical surgical floor. Your nurse manager has asked you to participate in preparing an in-service on a new skill needed to enhance the hospital’s partnership with community and outpatient settings.” 3. Answer this question: – What is ONE new knowledge, skills, or competency you feel is greatly needed to teach other nurses about developing partnership to improve population health? Provide your rationale.
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